IPILIMUMAB IPILIMUMAB (2638W) 2638W Body System: Antineoplastic And Immunomodulating Agents > Antineoplastic Agents > Monoclonal Antibodies And Antibody Drug Conjugates Manner of administration:Injection Private Chemotherapy Items for Private Hospital use Authority Required (STREAMLINED) Restriction (Streamlined authority code: 18069) Indication: Stage III melanoma Quantities & Cost Max amount # of repeats DPMA Max safety net General Patient Charge Max amount: 80 mg # of repeats: 1 DPMA: $10,978.43 Max safety net: $25.00 General Patient Charge: $25.00 Available brands Yervoy (ipilimumab 50 mg/10 mL injection, 10 mL vial) Yervoy (ipilimumab 200 mg/40 mL injection, 40 mL vial)
